The influence of portoenterostomy on transplantation for biliary atresia
- 1 October 2004
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Liver Transplantation
- Vol. 10 (10), 1279-1286
- https://doi.org/10.1002/lt.20234
Abstract
After portoenterostomy (PE) for biliary atresia (BA), many patients suffer progressive deterioration of liver function and ultimately require liver transplantation. We retrospectively reviewed a single center's experience with pediatric liver transplantation for BA from 1988 to 2002. Sixty‐six patients underwent 69 liver transplants for BA. Forty‐two (63%) patients had previously undergone Kasai PE, 11 (17%) biliary appendicoduodenostomy (BAD), and 13 (20%) had no prior biliary drainage (NBD). The BAD procedure offered only short‐term biliary drainage—the mean interval between PE and transplant was more than twice that for Kasai patients than for BAD patients (132 versus 49 weeks). The transplants included 11 cadaveric partial, 27 cadaveric whole, and 31 living related transplants. Three patients required retransplant. Prior PE did not increase the incidence of major perioperative complications or unplanned reexploration. After transplant, the 1‐, 5‐, and 10‐year actuarial graft survival rates were 87%, 86%, and 80%, respectively. The 1‐, 5‐, and 10‐year actuarial patient survival rates were 91%, 89%, and 83%. PE remains an important bridge to transplant. In conclusion, transplantation for BA offers excellent long‐term graft and patient survival. (Liver Transpl 2004;10:1279–1286.)Keywords
This publication has 40 references indexed in Scilit:
- Impact of Surgical and Immunological Parameters in Pediatric Liver TransplantationAnnals of Surgery, 2004
- History of pediatric liver transplantation. Where are we coming from? Where do we stand?Pediatric Transplantation, 2002
- Past and future of biliary atresiaJournal of Pediatric Surgery, 2000
- Prognosis of biliary atresia in the era of liver transplantation: French national study from 1986 to 1996Hepatology, 1999
- Long-term follow-up of patients with biliary atresia successfully treated with hepatic portoenterostomy. The importance of sequential treatment.Pediatric Surgery International, 1998
- Conventional treatment of biliary atresia: Long-term resultsJournal of Pediatric Surgery, 1996
- Biliary atresia: Current concepts and research directions. Summary of a symposiumHepatology, 1996
- Long-term outcome after surgery for biliary atresiaGastroenterology, 1990
- Surgical limitation for biliary atresia: Indication for liver transplantationJournal of Pediatric Surgery, 1989
- Progress in the treatment of biliary atresiaWorld Journal of Surgery, 1985